1
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Pastori D, Menichelli D, Di Rocco A, Farcomeni A, Sciacqua A, Pignatelli P, Fauchier L, Lip GYH. Bleeding and thrombotic events in patients with atrial fibrillation and cancer: a systematic review and meta-regression analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) and cancer are frequently coexisting in elderly patients. Pooled metanalytic data on the impact of cancer on outcomes in AF patients are lacking.
Purpose
We want to investigate the impact of cancer in patients with AF, particularly in relation to the incidence of bleeding and ischemic events
Methods
Systematic review and meta-regression analysis of clinical studies retrieved from Medline (PubMed) and Cochrane (CENTRAL) databases according to PRISMA guidelines. Safety endpoints included any, major, gastrointestinal (GI) bleeding and intracranial haemorrhage (ICH). Efficacy endpoints included myocardial infarction (MI), ischemic stroke/systemic embolism (IS/SE), cardiovascular (CV) and all-cause death.
Results
15 studies were included in the metanalysis: 4 prospective, 3 randomized clinical trials and 8 retrospective studies with 2,868,010 AF patients, of whom 479,571 (16.7%) had cancer. The pooled HR for cancer was 1.43 (95% CI 1.42–1.44) for any bleeding, 1.27 (95% CI 1.26–1.29) for major bleeding, 1.17 (95% CI 1.14–1.19) for GI bleeding, and 1.07 (95% CI 1.04–1.11) for ICH. The risk of major bleeding increased with the proportion of breast cancer. Cancer increased the risk of all-cause death (HR 2.00, 95% CI 1.99–2.02) whereas no association with MI (HR 0.97, 95% CI 0.94–1.01) and CV death (HR 1.01, 95% CI 0.99–1.03) was found. Patients with AF and cancer were less likely to suffer from IS/SE (HR 0.91, 95% CI 0.89–0.94).
Conclusion
The presence of cancer modifies the clinical history of AF patients, mainly increasing the risk of bleeding. Further analyses according to the type and stage of cancer is necessary to better stratify bleeding risk in these patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Pastori
- Sapienza University of Rome, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences , Rome , Italy
| | - D Menichelli
- Sapienza University of Rome, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences , Rome , Italy
| | - A Di Rocco
- Sapienza University of Rome, Department of Public Health and Infectious Diseases , Rome , Italy
| | - A Farcomeni
- University of Rome Tor Vergata, Department of Economics and Finance , Rome , Italy
| | - A Sciacqua
- Magna Graecia University of Catanzaro, Department of Medical and Surgical Sciences , Catanzaro , Italy
| | - P Pignatelli
- Sapienza University of Rome, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences , Rome , Italy
| | - L Fauchier
- University F. Rabelais of Tours , Tours , France
| | - G Y H Lip
- Liverpool Heart and Chest Hospital , Liverpool , United Kingdom
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Moia R, Favini C, Talotta D, Sagiraju S, Bruna R, Dondolin R, Della Starza I, Soscia R, Andorno A, Mercalli F, Deambrogi C, Rasi S, Petrucci L, Bellissimo T, Luciano Boldorini R, Di Rocco A, Del Giudice I, Martelli M, Foà R, Gaidano G. P1281: LIQUID BIOPSY PROVIDES COMPLEMENTARY INFORMATION TO TISSUE BIOPSIES FOR THE MOLECULAR CLASSIFICATION OF DLBCL PATIENTS. Hemasphere 2022. [PMCID: PMC9431283 DOI: 10.1097/01.hs9.0000847988.92666.b7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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3
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Chiappella A, Guidetti A, Dodero A, Bramanti S, Zinzani P, Santoro A, Casadei B, Di Rocco A, Carrabba M, Chiusolo P, Martino M, Barbui AM, Tisi MC, Miceli R, Carniti C, Corradini P. FIRST REPORT OF THE REAL‐LIFE PROSPECTIVE OBSERVATIONAL STUDY “CAR‐T CELL IN DIFFUSE LARGE B‐CELL AND PRIMARY MEDIASTINAL LYMPHOMAS” OF THE ITALIAN SOCIETY OF HEMATOLOGY. Hematol Oncol 2021. [DOI: 10.1002/hon.187_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- A. Chiappella
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - A. Guidetti
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - A. Dodero
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - S. Bramanti
- Humanitas Clinical and Research Center IRCCS Hematology Rozzano Italy
| | - P. Zinzani
- University of Bologna Institute of Hematology "Seràgnoli" Bologna Italy
| | - A. Santoro
- Humanitas Clinical and Research Center IRCCS Hematology Rozzano Italy
| | - B. Casadei
- University of Bologna Institute of Hematology "Seràgnoli" Bologna Italy
| | - A. Di Rocco
- 'Sapienza' University of Rome Department of Translational and Precision Medicine Roma Italy
| | - M. Carrabba
- San Raffaele Hospital IRCCS Hematology and Bone Marrow Transplantation Unit Milano Italy
| | - P. Chiusolo
- Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Department of Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Hematology Section Department of Scienze Radiologiche ed Ematologiche Roma Italy
| | - M. Martino
- Grande Ospedale Metropolitano “Bianchi‐Melacrino‐Morelli” Stem Cell Transplant and Cellular Therapies Unit Reggio Calabria Italy
| | - A. M. Barbui
- Azienda Socio Sanitaria Territoriale (ASST), Ospedale Papa Giovanni XXIII Hematology Unit Bergamo Italy
| | - M. C. Tisi
- San Bortolo Hospital Cell Therapy and Hematology Vicenza Italy
| | - R. Miceli
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Unit of Clinical Epidemiology and Trial Organization Department of Applied Research and Technological Development Milano Italy
| | - C. Carniti
- Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy Laboratory of Hematology Division of Hematology and Stem Cell Transplantation Milano Italy
| | - P. Corradini
- Chair of Hematology University of Milano Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Division of Hematology and Stem Cell Transplantation Milano Italy
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4
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Mariani S, Pelliccia S, Bianchi MP, Di Rocco A, Petrucci L, Maiolo E, Battistini R, Fanelli F, Tomei G, Palombi F, Papa E, Pupo L, Andriani A, Hoaus S, Cantonetti M, Tesei C, Tafuri A. IBRUTINIB IN PATIENTS WITH RELAPSED/REFRACTORY MANTLE CELL LYMPHOMA: REAL LIFE DATA FROM THE 'RETE EMATOLOGICA DEL LAZIO PER I LINFOMI' (RELLI). Hematol Oncol 2021. [DOI: 10.1002/hon.32_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- S Mariani
- A.O.U. Sant'Andrea, Sapienza University of Rome, Dipartimento di Medicina Clinica e Molecolare Rome Italy
| | - S Pelliccia
- A.O.U. Sant'Andrea, Sapienza University of Rome, Dipartimento di Medicina Clinica e Molecolare Rome Italy
| | - M. P Bianchi
- A.O.U. Sant'Andrea, Sapienza University of Rome, Dipartimento di Medicina Clinica e Molecolare Rome Italy
| | - A Di Rocco
- Hematology, Sapienza University of Rome, Department of Translational and Precision Medicine Rome Italy
| | - L Petrucci
- Hematology, Sapienza University of Rome, Department of Translational and Precision Medicine Rome Italy
| | - E Maiolo
- Università Cattolica S. Cuore, Department of Hematology Rome Italy
| | - R Battistini
- AO San Camillo‐Forlanini, Haematology and Haematopoietic Stem Cells Transplant Unit Rome Italy
| | - F Fanelli
- AO San Camillo‐Forlanini, Haematology and Haematopoietic Stem Cells Transplant Unit Rome Italy
| | - G Tomei
- Fabrizio Spaziani Hospital, Hematology Frosinone Italy
| | - F Palombi
- IRCCS Regina Elena National Cancer Institute, Hematology and Stem Cell Transplant Unit Rome Italy
| | - E Papa
- IRCCS Regina Elena National Cancer Institute, Hematology and Stem Cell Transplant Unit Rome Italy
| | - L Pupo
- Haematology Division, University of Tor Vergata, Department of Biomedicine and Prevention Rome Italy
| | - A Andriani
- Fabrizio Spaziani Hospital, Hematology Frosinone Italy
| | - S Hoaus
- Università Cattolica S. Cuore, Department of Hematology Rome Italy
| | - M Cantonetti
- Haematology Division, University of Tor Vergata, Department of Biomedicine and Prevention Rome Italy
| | - C Tesei
- A.O.U. Sant'Andrea, Sapienza University of Rome, Dipartimento di Medicina Clinica e Molecolare Rome Italy
| | - A Tafuri
- A.O.U. Sant'Andrea, Sapienza University of Rome, Dipartimento di Medicina Clinica e Molecolare Rome Italy
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5
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Cucca A, Mania D, Sharma K, Acosta I, Berberian M, Beheshti M, Biagioni M, Droby A, Di Rocco A, Ghilardi M, Inglese M, Rizzo J, Feigin A. Neural correlates of visuospatial dysfunction in Parkinson's Disease: A multimodal biomarker study. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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6
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Ferreri A, Sassone M, Angelillo P, Zaja F, Re A, Spina M, Di Rocco A, Fabbri A, Stelitano C, Frezzato M, Rusconi C, Zambello R, Arcari A, Bertoldero G, De Lorenzo D, Volpetti S, Calimeri T, Perrone S, Cecchetti C, Ciceri F, Ponzoni M. LONG-TERM EFFICACY AND SAFETY OF LENALIDOMIDE MAINTENANCE IN PATIENTS WITH RELAPSED DIFFUSE LARGE B-CELL LYMPHOMA WHO ARE NOT ELIGIBLE FOR AUTOLOGOUS TRANSPLANTATION (ASCT). Hematol Oncol 2019. [DOI: 10.1002/hon.65_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A.J. Ferreri
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - M.C. Sassone
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - P. Angelillo
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - F. Zaja
- SC Ematologia; Azienda Sanitaria Universitaria Integrata; Trieste Italy
| | - A. Re
- Division of Hematology; Spedali Civili; Brescia Italy
| | - M. Spina
- Oncologia; Centro di Riferimento Oncologico; Aviano Italy
| | - A. Di Rocco
- Division of Hematology; University ”La Sapienza”; Rome Italy
| | - A. Fabbri
- Division of Hematology; Azienda Ospedaliera Università Senese; Siena Italy
| | - C. Stelitano
- Division of Hematology; Azienda Ospedaliera Bianchi-Melacrino-Morelli; Reggio Calabria Italy
| | - M. Frezzato
- Division of Hematology; San Bortolo Hospital; Vicenza Italy
| | - C. Rusconi
- Division of Hematology; Niguarda Hospital; Milan Italy
| | - R. Zambello
- Division of Hematology; Azienda Ospedaliera di Padua; Padua Italy
| | - A. Arcari
- Department of Oncology and Hematology; Guglielmo da Saliceto Hospital; Piacenza Italy
| | - G. Bertoldero
- U.O. di Oncologia ed Ematologia Oncologica; Ospedale di Mirano; Mirano Italy
| | - D. De Lorenzo
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - S. Volpetti
- Clinica Ematologia; Azienda Sanitaria Universitaria Integrata, DAME; Udine Italy
| | - T. Calimeri
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - S. Perrone
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - C. Cecchetti
- Lymphoma Unit; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - F. Ciceri
- Onco-Hematology; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - M. Ponzoni
- Pathology; IRCCS San Raffaele Scientific Institute; Milan Italy
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7
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Visco C, Di Rocco A, Tisi M, Morello L, Evangelista A, Zilioli V, Rusconi C, Hohaus S, Sciarra R, Re A, Tecchio C, Chiappella A, Marin-Niebla A, McCulloch R, Gini G, Perrone T, Nassi L, Pennese E, Stefani P, Cox M, Bozzoli V, Fabbri A, Polli V, Ferrero S, De Celis I, Sica A, Arcaini L, Balzarotti M, Rule S, Vitolo U. OUTCOMES IN FIRST RELAPSED-REFRACTORY YOUNGER PATIENTS WITH MANTLE CELL LYMPHOMA: RESULTS FROM THE MANTLE-FIRST STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.16_2629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C. Visco
- Medicine, Section of Hematology; University of Verona; Verona Italy
| | - A. Di Rocco
- Translational and Precision Medicine; Sapienza University of Rome; Rome Italy
| | - M.C. Tisi
- Medicine, Section of Hematology; University of Verona; Verona Italy
| | - L. Morello
- Hematology; Humanitas Clinical and Research Center; Rozzano Italy
| | - A. Evangelista
- Clinical Epidemiology; Città della Salute e della Scienza and CPO Piemonte; Torino Italy
| | - V.R. Zilioli
- Hematology; ASST Grande Ospedale Metropolitano Niguarda; Milano Italy
| | - C. Rusconi
- Hematology; ASST Grande Ospedale Metropolitano Niguarda; Milano Italy
| | - S. Hohaus
- Institute of Hematology, Policlinico Gemelli Foundation; Catholic University of the Sacred Heart; Roma Italy
| | - R. Sciarra
- Haematology Oncology; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - A. Re
- Hematology; Spedali Civili; Brescia Italy
| | - C. Tecchio
- Medicine, Section of Hematology and Bone Marrow Transplant; University of Verona; Verona Italy
| | - A. Chiappella
- Hematology; Città della salute e della scienza University Hospital; Torino Italy
| | - A. Marin-Niebla
- Hematology; Vall d'Hebron Institut d'Oncologia (VHIO); Barcelona Spain
| | - R. McCulloch
- Haematology; University of Plymouth and Derriford Hospital; Plymouth United Kingdom
| | - G. Gini
- Hematology, Department of Clinical and Molecular Sciences; Marche Polytechnic University; Ancona Italy
| | - T. Perrone
- Hematology; University of Bari; Bari Italy
| | - L. Nassi
- Hematology; Azienda Ospedaliero-Universitaria Maggiore della Carità; Novara Italy
| | - E. Pennese
- Hematology; UOSD "Centro Diagnosi e Terapia dei Linfomi"; PO Santo Spirito Pescara Italy
| | - P.M. Stefani
- Hematology; Ca' Foncello Hospital; Treviso Italy
| | - M.C. Cox
- Hematology; AOU Sant'Andrea; Rome Italy
| | | | - A. Fabbri
- Hematology; Azienda Ospedaliera Universitaria Senese & University of Siena; Siena Italy
| | - V. Polli
- Hematology; Ospedale degli Infermi; Rimini Italy
| | - S. Ferrero
- Molecular Biotechnologies and Health Sciences; University of Torino/AOU "Città della Salute e della Scienza di Torino"; Torino Italy
| | - I.A. De Celis
- Hematology; AUSLL/IRCCS Santa Maria Nuova Hospital; Reggio Emilia Italy
| | - A. Sica
- Hematology; Policlinico di Napoli; Napoli Italy
| | - L. Arcaini
- Haematology Oncology; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - M. Balzarotti
- Hematology; Humanitas Clinical and Research Center; Rozzano Italy
| | - S. Rule
- Haematology; University of Plymouth and Derriford Hospital; Plymouth United Kingdom
| | - U. Vitolo
- Hematology; Città della salute e della scienza University Hospital; Torino Italy
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8
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Cucca A, Biagioni MC, Sharma K, Golomb J, Gilbert RM, Di Rocco A, Fleisher JE. Comorbid Normal Pressure Hydrocephalus with Parkinsonism: A Clinical Challenge and Call for Awareness. Case Rep Neurol Med 2018; 2018:2513474. [PMID: 29610690 PMCID: PMC5828340 DOI: 10.1155/2018/2513474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/06/2017] [Accepted: 12/24/2017] [Indexed: 12/13/2022] Open
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is the most common cause of hydrocephalus in adults. The diagnosis may be challenging, requiring collaborative efforts between different specialists. According to the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, iNPH should be considered in the differential of any unexplained gait failure with insidious onset. Recognizing iNPH can be even more difficult in the presence of comorbid neurologic disorders. Among these, idiopathic Parkinson's disease (PD) is one of the major neurologic causes of gait dysfunction in the elderly. Both conditions have their peak prevalence between the 6th and the 7th decade. Importantly, postural instability and gait dysfunction are core clinical features in both iNPH and PD. Therefore, diagnosing iNPH where diagnostic criteria of PD have been met represents an additional clinical challenge. Here, we report a patient with parkinsonism initially consistent with PD who subsequently displayed rapidly progressive postural instability and gait dysfunction leading to the diagnosis of concomitant iNPH. In the following sections, we will review the clinical features of iNPH, as well as the overlapping and discriminating features when degenerative parkinsonism is in the differential diagnosis. Understanding and recognizing the potential for concomitant disease are critical when treating both conditions.
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Affiliation(s)
- A. Cucca
- Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - M. C. Biagioni
- Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - K. Sharma
- Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - J. Golomb
- Department of Neurosurgery, Adult Hydrocephalus Program, NYU School of Medicine, New York, NY, USA
| | - R. M. Gilbert
- Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - A. Di Rocco
- Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, New York University School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - J. E. Fleisher
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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9
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Sassone M, Zaja F, Re A, Spina M, Di Rocco A, Fabbri A, Stelitano C, Frezzato M, Rusconi C, Zambello R, Calimeri T, Scarfò L, Cecchetti C, Chiozzotto M, Ponzoni M, Ferreri A. A multicentre phase II trial addressing lenalidomide (LEN) maintenance in patients with relapsed diffuse large b-cell lymphoma (rDLBCL) who are not eligible for autologous stem cell transplantation (ASCT). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Ferrero S, Rossi D, Bruscaggin A, Evangelista A, Di Rocco A, Spina V, Stefoni V, Ghione P, Barbero D, Monitillo L, Gomes Da Silva M, Santoro A, Molinari A, Ferreri A, Piccin A, Cortelazzo S, Ladetto M, Gaidano G. KMT2D AND TP53 MUTATIONS PREDICT POOR PFS AND OS IN MANTLE CELL LYMPHOMA RECEIVING HIGH-DOSE THERAPY AND ASCT: THE FONDAZIONE ITALIANA LINFOMI (FIL) MCL0208 PHASE III TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_83] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S. Ferrero
- Molecular Biotechnologies and Health Sciences - Hematology Division; Università di Torino; Torino Italy
| | - D. Rossi
- Hematology, Oncology; Institute of Southern Switzerland and Institute of Oncology Research; Bellinzona Switzerland
| | - A. Bruscaggin
- Hematology; Institute of Oncology Research; Bellinzona Switzerland
| | - A. Evangelista
- Clinical Epidemiology; Città della Salute e della Scienza and CPO Piemonte; Torino Italy
| | - A. Di Rocco
- Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I; "Sapienza" University of Rome; Rome Italy
| | - V. Spina
- Hematology; Institute of Oncology Research; Bellinzona Switzerland
| | - V. Stefoni
- University of Bologna; Institute of Hematology "L. e A. Seràgnoli; Bologna Italy
| | - P. Ghione
- Molecular Biotechnologies and Health Sciences - Hematology Division; Università di Torino; Torino Italy
| | - D. Barbero
- Molecular Biotechnologies and Health Sciences - Hematology Division; Università di Torino; Torino Italy
| | - L. Monitillo
- Molecular Biotechnologies and Health Sciences - Hematology Division; Università di Torino; Torino Italy
| | - M. Gomes Da Silva
- Department of Hematology; Instituto Português de Oncologia de Lisboa; Lisbona Portugal
| | - A. Santoro
- Humanitas Clinical and Research Center; Humanitas Cancer Center; Rozzano Italy
| | - A. Molinari
- Hematology; Ospedale degli Infermi; Rimini Italy
| | - A. Ferreri
- Unit of Lymphoid Malignancies, Department of Onco-Haematology; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - A. Piccin
- Department of Hematology; Ospedale Generale; Bolzano Italy
| | | | - M. Ladetto
- Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, SC Ematologia; Alessandria Italy
| | - G. Gaidano
- Department of Translational Medicine; University of Eastern Piedmont, Division of Hematology; Novara Italy
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11
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Ceriani L, Milan L, Martelli M, Ferreri A, Di Rocco A, Giovanella L, Cavalli F, Johnson P, Zucca E. METABOLIC HETEROGENEITY OF BASELINE 18-FDG PET-CT SCAN PREDICTS OUTCOME IN PRIMARY MEDIASTINAL B-CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L. Ceriani
- Nuclear Medicine and PET-CT Centre; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - L. Milan
- Nuclear Medicine and PET-CT Centre; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - M. Martelli
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - A.J. Ferreri
- Department of Oncology, Unit of Lymphoid Malignancies; San Raffaele Scientific Institute; Milan Italy
| | - A. Di Rocco
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - L. Giovanella
- Nuclear Medicine and PET-CT Centre; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - F. Cavalli
- Lymphoma Unit; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - P.W. Johnson
- Cancer Research UK Centre; University of Southampton; Southampton UK
| | - E. Zucca
- Lymphoma Unit; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
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12
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Morello L, Rattotti S, Jerkeman M, van Meerten T, Krawczyk K, Moita F, Marino D, Ferrero S, Szymczyk M, Aurer I, El-Galaly T, Di Rocco A, Carli G, Defrancesco I, Giordano L, Carlo-Stella C, Dreyling M, Santoro A, Arcaini L. MANTLE CELL LYMPHOMA OF MUCOSA-ASSOCIATED LYMPHOID TISSUE: A RETROSPECTIVE MULTICENTER OBSERVATIONAL STUDY OF THE EUROPEAN MANTLE CELL LYMPHOMA NETWORK. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- L. Morello
- Department of Oncology and Hematology; Humanitas Clinical and Research Center, Rozzano, Italy; Rozzano (MI) Italy
| | - S. Rattotti
- Department of Hematology and Oncology, Fondazione IRCCS Policlinico S. Matteo; University of Pavia, Italy; Pavia Italy
| | - M. Jerkeman
- Department of Oncology; Skane University Hospital; Lund Sweden
| | - T. van Meerten
- Department of Hematology; University Medical Center Groningen; Groningen The Netherlands
| | - K. Krawczyk
- Department of Hematology; Jagiellonian University; Krakow Poland
| | - F. Moita
- Instituto Português de Oncologia de Lisboa, Francisco Gentil; Lisbon Portugal
| | - D. Marino
- Oncology Unit 1; Veneto Institute of Oncology IOV-IRCCS; Padova Italy
| | - S. Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences; University of Torino; Torino Italy
| | - M. Szymczyk
- Department of Lymphoid Malignancies, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology; Warsaw Poland
| | - I. Aurer
- Division of Hematology, Department of Internal Medicine; University Hospital Centre Zagreb; Zagreb Croatia
| | - T.C. El-Galaly
- Department of Hematology; Aalborg University Hospital; Aalborg Denmark
| | - A. Di Rocco
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - G. Carli
- Department of Cell Therapy and Haematology; San Bortolo Hospital; Vicenza Italy
| | - I. Defrancesco
- Department of Hematology and Oncology, Fondazione IRCCS Policlinico S. Matteo; University of Pavia, Italy; Pavia Italy
| | - L. Giordano
- Department of Oncology and Hematology; Humanitas Clinical and Research Center, Rozzano, Italy; Rozzano (MI) Italy
| | - C. Carlo-Stella
- Department of Oncology and Hematology; Humanitas Clinical and Research Center, Rozzano, Italy; Rozzano (MI) Italy
| | - M. Dreyling
- Department of Internal Medicine III; Ludwig-Maximilians University Hospital Munich; Munchen Germany
| | - A. Santoro
- Department of Oncology and Hematology; Humanitas Clinical and Research Center, Rozzano, Italy; Rozzano (MI) Italy
| | - L. Arcaini
- Department of Hematology and Oncology, Fondazione IRCCS Policlinico S. Matteo; University of Pavia, Italy; Pavia Italy
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Pestell RG, Di Sante G, Di Rocco A, Pupo C, Crosariol M, Tompa P, Tantos A, Wang C, Yu Z, Vadlamudi R, Mann M, Casimiro MC. Abstract P5-06-09: Cyclin d1 binding to chromatin and the induction of chromosomal instability requires the fuzzy domain. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-06-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The cyclin D1 gene encodes the regulatory subunit of a holoenzyme that phosphorylates and inactivates the retinoblastoma (Rb) and the nuclear respiratory factor 1 (NRF1) proteins to regulate nuclear DNA synthesis and mitochondrial biogenesis. Cyclin D1 is required for oncogene-dependent growth and genetic ablation of the murine cyclin D1 gene resulted in resistance to Ras or ErbB2-induced mammary tumorigenesis and APC-induced gastrointestinal tumorigenesis. Cyclin D1 overexpression occurs in human breast, prostate, lung, and gastrointestinal malignancies and its abundance is induced at the level of transcription, translation and through post-translational modifications. Cyclin D1 plays a key role in transcriptional regulation inducing gene expression governing chromosomal instability (CIN) and cell-cycle progression. Cyclin D1 is also known to bind TF regulatory regions in chromatin immuno-precipitation (ChIP) assays. Genome wide analysis of cyclin D1 occupancy using ChIP-Seq identified binding sites including both the coding and non-coding genome with enrichment for genes regulating CIN and the G2/M phase (Top2A, AurkB, Cenpp, Mlf1ip, Zw10, Ckap2) consistent with enrichment of cyclin D1 at G2/M and the finding that cyclin D1 induces CIN. We sought to identify the molecular mechanisms governing the recruitment of cyclin D1 in the context of local chromatin to promote CIN. In order to define the domain of cyclin D1 involved in aneuploidy and tumorigenesis, we transduced and assessed the induction of aneuploidy in MEF cells using cyclin D1 wt (wt), cyclin D1 C-terminus domain (C4), cyclin D1 mutant lacking of the E-box motif (ΔE) or ctrl. We also searched for potential histone protein interaction motifs in cyclin D1 and determined the epigenetic motif recognized by cyclin D1 using a histone peptide array. The recognition of an epigenetic code by cyclin D1 may facilitate genome wide expression changes during cell-cycle progression and tumorigenesis. We finally identified a “fuzzy” domain of cyclin D1 which is required to local chromatin access for regulatory promoter regions governing and promoting CIN.
Citation Format: Pestell RG, Di Sante G, Di Rocco A, Pupo C, Crosariol M, Tompa P, Tantos A, Wang C, Yu Z, Vadlamudi R, Mann M, Casimiro MC. Cyclin d1 binding to chromatin and the induction of chromosomal instability requires the fuzzy domain [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-06-09.
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Affiliation(s)
- RG Pestell
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - G Di Sante
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - A Di Rocco
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - C Pupo
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - M Crosariol
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - P Tompa
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - A Tantos
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - C Wang
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - Z Yu
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - R Vadlamudi
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - M Mann
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
| | - MC Casimiro
- Thomas Jefferson University; VIB Structural Biology Research Center; University of Texas Health Sciences Center
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Gravina GL, Festuccia C, Popov VM, Di Rocco A, Colapietro A, Sanità P, Monache SD, Musio D, De Felice F, Di Cesare E, Tombolini V, Marampon F. c-Myc Sustains Transformed Phenotype and Promotes Radioresistance of Embryonal Rhabdomyosarcoma Cell Lines. Radiat Res 2017; 185:411-22. [PMID: 27104757 DOI: 10.1667/rr14237.1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We have previously reported that the MEK/ERK pathway sustains in vitro and in vivo transformed phenotype and radioresistance of embryonal rhabdomyosarcoma (ERMS) cell lines. Furthermore, we found that aberrant MEK/ERK signaling activation promotes c-Myc oncoprotein accumulation. In this study, the role of c-Myc in sustaining the ERMS transformed and radioresistant phenotype is characterized. RD and TE671 cell lines conditionally expressing MadMyc chimera protein, c-Myc-dominant negative and shRNA directed to c-Myc were used. Targeting c-Myc counteracted in vitro ERMS adherence and in suspension, growth motility and the expression of pro-angiogenic factors. c-Myc depletion decreased MMP-9, MMP-2, u-PA gelatinolytic activity, neural cell adhesion molecule sialylation status, HIF-1α, VEGF and increased TSP-1 protein expression levels. Rapid but not sustained targeting c-Myc radiosensitized ERMS cells by radiation-induced apoptosis, DNA damage and impairing the expression of DNA repair proteins RAD51 and DNA-PKcs, thereby silencing affected ERMS radioresistance. c-Myc sustains ERMS transformed phenotype and radioresistance by protecting cancer cells from radiation-induced apoptosis and DNA damage, while promoting radiation-induced DNA repair. This data suggest that c-Myc targeting can be tested as a promising treatment in cancer therapy.
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Affiliation(s)
- G L Gravina
- a Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - C Festuccia
- a Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - V M Popov
- b Department of Radiation Oncology, Perelman School of Medicine, Penn Center for Innovation Fellow, University of Pennsylvania, Philadelphia, Pennsylvania
| | - A Di Rocco
- c Department of Orthopedics/Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - A Colapietro
- a Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Sanità
- a Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - S Delle Monache
- a Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - D Musio
- d Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - F De Felice
- d Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - E Di Cesare
- a Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - V Tombolini
- d Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - F Marampon
- a Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Moisello C, Crupi D, Di Rocco A, Eidelberg D, Feigin A, Ghilardi F. P3.133 Regulation of movement energetic costs is impaired in basal ganglia disorders. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ghilardi M, Marinelli L, Moisello C, Abbruzzese G, Di Rocco A. 1.199 Increased reaction time predicts deficit of explicit visual learning in the early stages of Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pelosin E, Bove M, Marinelli L, Moisello C, Di Rocco A, Ghilardi M, Abbruzzese G. 1.257 Cervical dystonia: Effect of botulinum toxin on trajectory formation. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70498-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ghilardi M, Bassiri-Tehrani M, Maldonado N, Moisello C, Di Rocco A, Eidelberg D, Crupi D. 1.197 Sequence learning and the basal ganglia. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70469-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Ketones may bypass the defect in complex I activity implicated in Parkinson disease (PD). Five of seven volunteers with PD were able to prepare a "hyperketogenic" diet at home and adhere to it for 28 days. Substituting unsaturated for saturated fats appeared to prevent cholesterol increases in four volunteers. Unified Parkinson's Disease Rating Scale scores improved in all five during hyperketonemia, but a placebo effect was not ruled out.
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Affiliation(s)
- T B Vanitallie
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, St. Luke's-Roosevelt Hospital Center, New York, USA.
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Di Rocco A, Finolezzi E, Anaclerico B, Calabrese E, Levi A, Trasarti S, Tafuri A. [Therapeutic advances in neoplastic hematology: target therapy anti-CD33]. Clin Ter 2005; 156:183-6. [PMID: 16342520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Antibodies capable to recognize antigen expressed on cancer cells represents the ideal approach for targeted anti neoplastic therapies. The CD33 antigen is present on 90% of acute myeloid leukemia blasts and is shared on normal hemopoietic cells only on the non stem dillerentiating fraction. Gemtuzumab Ozogamicin (GO) is an engineered humanized antibody anti-CD33 conjugated with a potent intercalating agent, named calicheamicin, which is release only at intracellular level (lower pH), following a selective binding to CD33-positive cells, thus representing a promising approach for target anti-leukemia therapy. GO was approved conditionally by the Federal Drug Administration in May 2000 as a single therapy for first recurrence of Acute Myeloid Leukemia (AML) in a subset of older patients. Since 2000, treatment trials and pilot studies have revealed potential expanded applications along with potential limitations. Phase II trials have confirmed the activity and the efficacy of GO as single agent in the treatment of relapsed AML. More recently, clinical trials on induction and post-remission treatment of adult AML have shown efficacy of GO in combination chemotherapy. The strong and homogeneous CD33 expression in Acute Promyelocytic Leukemia (APL), have resulted in an effective treatment of this disease with GO used as salvage treatment, as well as innovative approach for molecular relapsed patients. However, the incidence of veno-occlusive disease, better defined as sinusoidal occlusive syndrome (SOS), must be taken into account as potential complication associated with the GO administration, especially in patients treated with ablative regimens. In conclusion, the extension of the approval in Italy to AML CD33+ in relapsed, regardless age limitation, along with the ongoing evaluation by the European EMEA, represent the basis for a large clinical application of GO in myeloid malignancies potentially extended to paediatric patients with AML and to ALL CD33+.
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MESH Headings
- Acute Disease
- Adult
- Aged
- Aminoglycosides/therapeutic use
- Antibiotics, Antineoplastic/therapeutic use
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antigens, CD
- Antigens, Differentiation, Myelomonocytic
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Child
- Clinical Trials as Topic
- Clinical Trials, Phase II as Topic
- Enediynes
- Gemtuzumab
- Humans
- Immunotoxins/therapeutic use
- Leukemia, Myeloid/drug therapy
- Leukemia, Promyelocytic, Acute/drug therapy
- Middle Aged
- Pilot Projects
- Recurrence
- Sialic Acid Binding Ig-like Lectin 3
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Affiliation(s)
- A Di Rocco
- Ematologia, Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Roma, Italia.
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Mazzella L, Yahr MD, Marinelli L, Huang N, Moshier E, Di Rocco A. Dyskinesias predict the onset of motor response fluctuations in patients with Parkinson's disease on L-dopa monotherapy. Parkinsonism Relat Disord 2005; 11:151-5. [PMID: 15823479 DOI: 10.1016/j.parkreldis.2004.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2003] [Revised: 10/06/2004] [Accepted: 10/13/2004] [Indexed: 11/26/2022]
Abstract
The aim of the study was to investigate the relationship between dyskinesias and motor fluctuations in patients with Parkinson's disease on l-dopa monotherapy. We identified 116 patients on l-dopa monotherapy treated between 1965 and 1992 and followed until death. Dyskinesias occurred in 102 patients. Of these, 48 only developed dyskinesias while 54 had both dyskinesias and motor fluctuations. Among patients with both complications, 49 developed dyskinesias before fluctuations, and only five had dyskinesias after the onset of fluctuations. Our findings suggest that dyskinesias predict the onset of motor fluctuations, and may share a common pathophysiological mechanism.
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Affiliation(s)
- L Mazzella
- Department of Neurology, Beth Israel Medical Center-Albert Einstein College of Medicine, PACC-10 Union Square East #5K, New York, NY 10003, USA
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Di Rocco A, Werner P, Bottiglieri T, Godbold J, Liu M, Tagliati M, Scarano A, Simpson D. Treatment of AIDS-associated myelopathy with L-methionine: A placebo-controlled study. Neurology 2004; 63:1270-5. [PMID: 15477550 DOI: 10.1212/01.wnl.0000140469.18782.05] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The histopathology of AIDS-associated myelopathy (AM) closely resembles that of myelopathies due to cobalamin or folate deficiency, with white matter vacuolization in the spinal cord. The pathogenesis of AM appears unrelated to direct HIV infection of the spinal cord. There is abnormal trans-methylation metabolism in AM, with decreased availability of the methyl group donor S-adenosyl-methionine (SAM). The authors hypothesized that treatment with l-methionine, the direct metabolic precursor of SAM, might improve AM. OBJECTIVE To determine the safety and efficacy of l-methionine treatment in AM. METHODS Fifty-six patients with clinical diagnosis of AM were randomized to a Phase II, double-blind, placebo-controlled study comparing the effect of l-methionine 6 g/day in two divided doses with that of placebo. Study duration was 12 weeks. All patients had somatosensory evoked potentials with prolonged central conduction time (CCT) at entry. Change in CCT was the primary endpoint of the study. Frequency of adverse events (AEs) was used to assess safety. Secondary endpoints were strength, spasticity, and urinary function. Biochemical measurements included serum methionine and homocysteine and CSF SAM. RESULTS There were no significant differences in AEs between the two groups. Serum homocysteine increased in l-methionine-treated patients from 7.2 (+/-5.2 SD) to 12.6 (+/-6.15 SD) micromol/L. The mean CCT at baseline was 25.9 milliseconds (+/-7.3 SD) for the treatment group and 24.1 milliseconds (+/-7.0 SD) for the placebo group. At completion, it was 3.0 milliseconds (+/-6.1 SD) for the treatment group and 23.6 milliseconds (+/-5.5 SD) for the placebo group (p = 0.17). In a subset of 15 patients with CSF studies, SAM levels increased in the l-methionine but not in the placebo group (p = 0.07). There was no significant effect of treatment on strength, spasticity, or urinary function. CONCLUSIONS l-methionine was safe and well tolerated although in some patients induced an increase of serum homocysteine. There was a nonsignificant improvement in CCT in treated patients but no benefit in any of the clinical measures.
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Affiliation(s)
- A Di Rocco
- Department of Neurology, Albert Einstein College of Medicine-Beth Israel Medical Center, PACC, 10 Union Square East, 2R, New York, NY 10003, USA.
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Di Rocco A, Werner P, Schroecksnadel K, Leblhuber F, Fuchs D, Miller JW. Effect of L-dopa on plasma homocysteine in PD patients: Relationship to B-vitamin status. Neurology 2004. [DOI: 10.1212/wnl.62.4.676] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Di Rocco A, Bottiglieri T, Werner P, Geraci A, Simpson D, Godbold J, Morgello S. Abnormal cobalamin-dependent transmethylation in AIDS-associated myelopathy. Neurology 2002; 58:730-5. [PMID: 11889235 DOI: 10.1212/wnl.58.5.730] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND White matter vacuolization of the spinal cord is common in patients with AIDS and may lead to clinical manifestations of myelopathy. The pathogenesis of AIDS-associated myelopathy (AM) is unknown and may be related to metabolic abnormalities rather than to direct HIV infection. The striking pathologic similarity between AM and the vacuolar myelopathy associated with vitamin B(12) deficiency suggests that abnormal metabolism of the B(12)-dependent transmethylation pathway may be important in the pathogenesis of AM. METHODS The authors compared S-adenosyl-methionine (SAM), methionine, homocysteine, and glutathione in serum and CSF of 15 patients with AM vs. 13 HIV-infected controls without myelopathy (HWM). They also compared the results with a non-HIV--infected reference population (NC). All patients had normal B(12), folate, and methylmalonic acid levels. RESULTS There was a decrease in CSF SAM in the AM group compared with the HWM group (p < 0.0001) and the NC group (p < 0.0001). CSF SAM in the HWM group was also lower than that in the NC group (p = 0.015). Serum methionine was also reduced in serum of the myelopathic group compared with the NC group (p = 0.006). CONCLUSIONS AM is associated with an abnormality of the vitamin B(12)-dependent transmethylation pathway.
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Affiliation(s)
- A Di Rocco
- Department of Neurology, Albert Einstein College of Medicine and Beth Israel Medical Center, New York, NY 10003, USA.
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26
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Werner P, Di Rocco A, Prikhojan A, Rempel N, Bottiglieri T, Bressman S, Yahr MD. COMT-dependent protection of dopaminergic neurons by methionine, dimethionine and S-adenosylmethionine (SAM) against L-dopa toxicity in vitro. Brain Res 2001; 893:278-81. [PMID: 11223018 DOI: 10.1016/s0006-8993(00)03298-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
L-dopa may be toxic to dopamine neurons, possibly due to catechol-autoxidation. Catechols are O-methylated by catechol-O-methyltransferase (COMT) in a SAM consuming reaction, preventing the initiation of catechol autoxidation. We hypothesized that SAM or SAM-precursors ameliorate L-dopa neurotoxicity, in a COMT-dependent fashion. We tested this hypothesis in primary mesencephalic cultures by adding 200 microM L-dopa with 2 mM methionine or 1 mM dimethionine or 0.5 mM SAM with or without 0.2 microM of the COMT-inhibitor 2', 5'-dinitrocatechol (OR 486). L-dopa was found to be neurotoxic as the surviving neurons had fewer and shorter processes. Methionine, dimethionine and SAM all protected DA neurons against damaged induced by L-dopa. The COMT inhibitor dinitrocatechol (DNC) completely abolished the protective effect against L-dopa toxicity. We conclude that supplementation with methionine, dimethionine or SAM ameliorates L-dopa neurotoxicity to dopamine neurons, while inhibition of COMT may aggravate or unmask L-dopa neurotoxicity.
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Affiliation(s)
- P Werner
- Department of Neurology, Albert Einstein College of Medicine and Beth Israel Medical Center, F-121N, 1300 Morris Park Ave., Bronx, New York, NY, USA.
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Tagliati M, Di Rocco A, Danisi F, Simpson D. THE ROLE OF SOMATOSENSORY EVOKED POTENTIALS IN THE DIAGNOSIS OF AIDS‐ASSOCIATED MYELOPATHY. J Peripher Nerv Syst 2000. [DOI: 10.1111/j.1529-8027.2000.22-21.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Tagliati
- Neurology 54: 1477–1482, 2000. Reprinted with permission from Lippincott Williams & Wilkins
| | - A Di Rocco
- Neurology 54: 1477–1482, 2000. Reprinted with permission from Lippincott Williams & Wilkins
| | - F Danisi
- Neurology 54: 1477–1482, 2000. Reprinted with permission from Lippincott Williams & Wilkins
| | - Dm Simpson
- Neurology 54: 1477–1482, 2000. Reprinted with permission from Lippincott Williams & Wilkins
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Tagliati M, Di Rocco A, Danisi F, Simpson D. THE ROLE OF SOMATOSENSORY EVOKED POTENTIALS IN THE DIAGNOSIS OF AIDS-ASSOCIATED MYELOPATHY. J Peripher Nerv Syst 2000. [DOI: 10.1046/j.1529-8027.2000.00022-21.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
We report a pilot study of S-adenosyl-methionine (SAM) in 13 depressed patients with Parkinson's disease. All patients had been previously treated with other antidepressant agents and had no significant benefit or had intolerable side effects. SAM was administered in doses of 800 to 3600 mg per day for a period of 10 weeks. Eleven patients completed the study, and 10 had at least a 50% improvement on the 17-point Hamilton Depression Scale (HDS). One patient did not improve. Two patients prematurely terminated participation in the study because of increased anxiety. One patient experienced mild nausea, and another two patients developed mild diarrhea, which resolved spontaneously. The mean HDS score before treatment was 27.09 +/- 6.04 (mean +/- standard deviation) and was 9.55 +/- 7.29 after SAM treatment (p < 0.0001). Although uncontrolled and preliminary, this study suggests that SAM is well tolerated and may be a safe and effective alternative to the antidepressant agents currently used in patients with Parkinson's disease.
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Affiliation(s)
- A Di Rocco
- Department of Neurology, Beth Israel Medical Center-Albert Einstein College of Medicine, New York, NY 10003, USA
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Geraci A, Di Rocco A, Liu M, Werner P, Tagliati M, Godbold J, Simpson D, Morgello S. AIDS myelopathy is not associated with elevated HIV viral load in cerebrospinal fluid. Neurology 2000; 55:440-2. [PMID: 10932285 DOI: 10.1212/wnl.55.3.440] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The pathogenesis of AIDS-associated myelopathy is unknown. Elevated HIV-1 viral load in CSF has been associated with cognitive impairment. The authors investigated if a similar association exists in patients with myelopathy. The authors evaluated levels of HIV-1 RNA in the CSF of 16 individuals with AIDS myelopathy and in 16 nonmyelopathic HIV-infected control subjects. There was no correlation between levels of HIV-1 RNA and the presence or severity of myelopathy.
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Affiliation(s)
- A Geraci
- Albert Einstein College of Medicine and Beth Israel Medical Center, New York, NY 10003, USA
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Abstract
The most common disease of the spinal cord in human immunodeficiency virus (HIV) infection is vacuolar myelopathy. Pathology studies have demonstrated that vacuolization in the thoracic spinal cord is present in more than a third of patients with AIDS. The disease, however, manifests clinically only when the vacuolization in the spinal cord has become severe, with prominent myelin loss in the lateral and posterior columns. Vacuolar myelopathy presents usually with slowly progressing spastic paraparesis, accompanied by loss of vibratory and position sense and urinary frequency and urgency. In males, erectile dysfunction can be an early manifestation of the disease. The pathogenesis of vacuolar myelopathy is unknown but may be related to abnormal trans-methylation mechanisms induced by the HIV virus and cytokines. There is no known treatment for the disease, although therapy with methylating agents is being investigated. There are other rarer causes of spinal cord disease in AIDS, including a number of infectious myelitis and neoplastic and vascular myelopathies.
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Affiliation(s)
- A Di Rocco
- Beth Israel Medical Center, Albert Einstein College of Medicine, Department of Neurology, New York, New York, USA
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Abstract
BACKGROUND Although AIDS-associated vacuolar myelopathy is detected in >50% of autopsy cases, it is often unrecognized during life. The clinical assessment is often difficult because of concurrent peripheral neuropathy and lack of specific diagnostic markers. Somatosensory evoked potentials (SEPs) have been successfully used to evaluate central conduction in a number of diseases involving the spinal cord. OBJECTIVES To assess the diagnostic yield of SEPs in AIDS-associated myelopathy. METHODS We recorded tibial and median nerve SEPs in 69 HIV-infected subjects referred for evaluation of lower extremity neurologic abnormalities. Stimulation of the peroneal nerve at the popliteal fossa was performed in patients with absent response to ankle stimulation. RESULTS HIV-infected subjects had significantly delayed latencies of both peripheral and central potentials, suggesting a combination of peripheral and CNS abnormalities. Analysis of peripheral and central latencies allowed us to discriminate between neuropathy and myelopathy in individual patients. Abnormalities of tibial central conduction time (CCT) correlated with clinical diagnosis of myelopathy. There was no significant difference in median CCTs between patients and controls, suggesting that conduction abnormalities were restricted to the thoracolumbar spinal cord. A derived spinal conduction time was a sensitive indicator of central conduction abnormalities in AIDS patients with myelopathy. CONCLUSIONS The combination of median, posterior tibial, and peroneal SEPs is a valuable tool in the diagnosis of AIDS-associated myelopathy, particularly when myelopathy and peripheral neuropathy coexist. The use of a derived spinal conduction time improves the diagnostic yield of SEPs in AIDS-associated myelopathy.
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Affiliation(s)
- M Tagliati
- Department of Neurology, Clinical Neurophysiology, The Mount Sinai Medical Center, New York, NY 10003, USA.
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Di Rocco A, Werner P. Levodopa induces a cytoplasmic localization of D1 dopamine receptors in striatal neurons in Parkinson's disease. Ann Neurol 2000. [DOI: 10.1002/1531-8249(200001)47:1<136::aid-ana25>3.0.co;2-r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Di Rocco A, Werner P. Levodopa induces a cytoplasmic localization of D1 dopamine receptors in striatal neurons in Parkinson's disease. Ann Neurol 2000; 47:136-7. [PMID: 10632116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Chong J, Di Rocco A, Tagliati M, Danisi F, Simpson DM, Atlas SW. MR findings in AIDS-associated myelopathy. AJNR Am J Neuroradiol 1999; 20:1412-6. [PMID: 10512221 PMCID: PMC7657747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND AND PURPOSE The most common cause of spinal cord disease among patients with AIDS or those infected with HIV-1 is AIDS-associated myelopathy. The purpose of this study was to determine the MR characteristics of the spinal cord in this patient population and to correlate these findings with the clinical severity of myelopathy. METHODS MR images of the spinal cord in 21 patients with documented HIV-1 infection or AIDS and a clinical diagnosis of AIDS-associated myelopathy were assessed retrospectively for atrophy, intrinsic signal abnormality, and abnormal enhancement. The clinical severity of myelopathy was graded by a neurologist on the basis of physical examination, and a qualitative correlation was made with the MR findings. RESULTS MR findings were abnormal in 18 of the 21 patients. The most common feature was spinal cord atrophy (n = 15), typically involving the thoracic cord with or without cervical cord involvement, followed by intrinsic cord signal abnormality (n = 6), and normal-appearing cord (n = 3). Three patients had both cord atrophy and intrinsic cord signal abnormality. The cord signal abnormality was diffuse, without predilection for any specific distribution pattern. Enhancement was not seen in any of the 10 patients who received intravenous contrast material. Only one of 16 patients with moderate to severe myelopathy had normal MR findings, as compared with two of five patients with mild myelopathy. CONCLUSION MR findings in the spinal cord are abnormal in the majority of patients with AIDS-associated myelopathy, typically showing spinal cord atrophy, with or without intrinsic cord signal abnormality. Patients with moderate to severe myelopathy have an increased frequency of spinal cord abnormalities, but a definite correlation between clinical severity of myelopathy and extent of MR abnormalities remains to be established.
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Affiliation(s)
- J Chong
- Department of Radiology, Mount Sinai School of Medicine, New York, USA
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Di Rocco A. A randomized, double-blind, placebo-controlled trial of deprenyl and thiotic acid in HIV-associated cognitive impairment. Neurology 1999; 52:1920; author reply 1920-1. [PMID: 10371553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Di Rocco A, Roesler R, Quevedo J, Walz R, Bianchin M, Sacktor N. A randomized, double-blind, placebo-controlled trial of deprenyl and thiotic acid in HIV-associated cognitive impairment. Neurology 1999. [DOI: 10.1212/wnl.52.9.1920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Di Rocco A, Brannan T, Prikhojan A, Yahr MD. Sertraline induced parkinsonism. A case report and an in-vivo study of the effect of sertraline on dopamine metabolism. J Neural Transm (Vienna) 1998; 105:247-51. [PMID: 9660102 DOI: 10.1007/s007020050053] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a patient with a parkinsonian syndrome induced by sertraline (Zoloft), an SSRI antidepressant, whose symptoms resolved after the drug was discontinued. This case prompted us to investigate the effect of sertraline on dopamine metabolism in animals. Sertraline (30 mg/kg, i.p.) or placebo (vehicle) was administered to two groups of six normal, anesthetized rats and using cerebral microdyalisis extracellular striatal levels of dopamine, the dopamine metabolites (HVA and DOPAC), as well as the serotonin metabolite 5-HIIA were monitored. In animals pre-treated with sertraline, DOPAC, HVA, and 5-HIAA levels were significantly decreased compared to control animals (p < 0.01). These data indicate that sertraline has an effect on dopamine metabolism, which may alter function in the striatum and induce a parkinsonian syndrome.
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Affiliation(s)
- A Di Rocco
- The Mount Sinai Medical Center, Department of Neurology, New York, NY, USA
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Abstract
The pathogenesis of AIDS-associated vacuolar myelopathy (VM) may be related to abnormality of transmethylation mechanisms in the nervous system. To evaluate the safety and potential efficacy of the methyl-group donor L-methionine in AIDS-associated VM, we conducted a pilot clinical trial in 12 patients with VM. Seven of the nine patients who completed the study had clinical and electrophysiologic improvement. Controlled studies may be indicated to assess the efficacy and safety of L-methionine in AIDS-associated VM.
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Affiliation(s)
- A Di Rocco
- Department of Neurology, The Mount Sinai Medical Center, New York, NY, USA
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Abstract
AIDS-associated vacuolar myelopathy (VM) is a common neurologic complication of AIDS. Pathologically, VM is characterized by vacuolization in the lateral and posterior columns of the thoracic spinal cord and has a striking similarity with the myelopathy of vitamin B12 deficiency. In autopsy series, 20% to 55% of patients with AIDS have evidence of spinal cord disease consistent with VM. The myelopathy usually manifests late in the course of HIV infection, with slowly progressive weakness of the lower extremities, gait disorder, sensory abnormalities in the legs, impotence in men, and urinary frequency and urgency. Its course is invariably progressive and leads to severe paralysis of the lower limbs, with loss of the ability to walk and of sphincter control. The differential diagnosis is extensive and includes metabolic, infective, and neoplastic spinal cord diseases. The diagnosis is based on the clinical observation and the exclusion of other causes of myelopathy via serologic, radiographic, and cerebrospinal fluid studies. The pathogenesis of VM is unknown. Attempts to detect HIV in the spinal cord have not yielded significant results, and there is no evidence of a relationship between the presence of HIV and the development of myelopathy. A metabolic disorder of the vitamin B12-dependent transmethylation pathway, induced by HIV or cytokine activation, is considered the possible cause of VM associated with AIDS. There is no known treatment for AIDS myelopathy and there is no evidence that antiretroviral drugs can improve the symptoms or slow the progression of VM. The symptomatic treatment includes antispasticity agents, management of sphincter dysfunction, and physical therapy. Experimental treatments are being tested in clinical trials.
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Affiliation(s)
- A Di Rocco
- Department of Neurology, Beth Israel Medical Center-Albert Einstein College of Medicine, New York, NY, USA
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Di Rocco A. Neurology and murderers. Neurology 1996; 47:1610; author reply 1610-1. [PMID: 8960766 DOI: 10.1212/wnl.47.6.1610-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Affiliation(s)
- S P Molinari
- Department of Neurology, Mount Sinai Medical Center, New York, NY 10029-6574, USA
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46
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Molinari SP, Kaminski R, Di Rocco A, Yahr MD. The use of famotidine in the treatment of Parkinson's disease: a pilot study. J Neural Transm Park Dis Dement Sect 1995; 9:243-7. [PMID: 8527008 DOI: 10.1007/bf02259665] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Seven patients with idiopathic Parkinson's disease were enrolled in a ten week study to evaluate the efficacy of famotidine, an histamine H2-antagonist, in the treatment of bradyphrenia. Patients received famotidine 80 mg/day for a period of six weeks and were evaluated with neuropsychological tests. Overall, patients demonstrated improvement in variables measured. Some patients also reported an improvement in their motor symptoms.
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Affiliation(s)
- S P Molinari
- Department of Neurology, Mount Sinai Medical Center, New York, NY, USA
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47
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Mytilineou C, Werner P, Molinari S, Di Rocco A, Cohen G, Yahr MD. Impaired oxidative decarboxylation of pyruvate in fibroblasts from patients with Parkinson's disease. J Neural Transm Park Dis Dement Sect 1994; 8:223-8. [PMID: 7748465 DOI: 10.1007/bf02260943] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Whether or not a reported deficiency in brain mitochondrial complex I activity in Parkinson's disease represents a defect encompassing other organs or tissues has been a source of some controversy. We have examined mitochondrial respiration in fibroblasts from patients with Parkinson's disease by measuring the oxidative decarboxylation of [2-14C]pyruvate and [1,4-14C]succinate. We report that oxidation of pyruvate but not succinate was significantly reduced in fibroblasts from Parkinson patients when compared to healthy controls. These observations support the view that a widespread deficit in mitochondrial respiration exists in Parkinson's disease. Fibroblast cultures, moreover, are a source of affected proliferating cells, which can be used for in vitro studies of the nature of the respiratory defect and for testing of pharmacological interventions to correct the deficiency.
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Affiliation(s)
- C Mytilineou
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA
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Abstract
Two patients with biopsy-proven Creutzfeldt-Jakob disease had MRI studies that revealed increased signal in the basal ganglia on T-2 weighted images, suggesting that MRI can be a useful diagnostic instrument in Creutzfeldt-Jakob disease.
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Affiliation(s)
- A Di Rocco
- Department of Neurology, Mount Sinai Medical Center, New York, New York 10029-6574
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Brannan T, Martínez-Tica J, Di Rocco A, Yahr MD. Low and high dose bromocriptine have different effects on striatal dopamine release: an in vivo study. J Neural Transm Park Dis Dement Sect 1993; 6:81-7. [PMID: 7509606 DOI: 10.1007/bf02261001] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We wished to determine if low and high doses of bromocriptine produce distinct patterns of dopamine release and metabolism. Accordingly, we administered bromocriptine (0, 2.5, 5, and 10 mg/kg, IP) to rats and monitored extracellular concentrations of dopamine and dopamine metabolites in the corpus striatum with the technique of cerebral microdialysis. Extracellular dopamine levels increased following administration of 2.5 and 5 mg/kg bromocriptine. In contrast, dopamine levels decreased following 10 mg/kg bromocriptine. Dopamine metabolite levels decreased 45 minutes following all doses of bromocriptine. Bromocriptine administration had no effect on the levels of 5HIAA, the major serotonin metabolite. These findings with high dose bromocriptine fit the predicted profile of a dopamine D2 receptor agonist. The delayed decrease in dopamine metabolites at all bromocriptine doses is consistent with the known dopamine synthesis inhibiting action of bromocriptine. In contrast, the increased dopamine release observed following low and medium doses of bromocriptine is not readily explainable by current theories of bromocriptine action which predict decreased dopamine release and therefore decreased striatal extracellular dopamine levels with both high and low-doses of bromocriptine. Our findings indicate that bromocriptine has a complex pharmacological action that extends beyond simple agonism at dopamine D2 receptors.
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Affiliation(s)
- T Brannan
- Department of Neurology, Mount Sinai School of Medicine, New York, NY
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50
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De Blasis G, Sedici A, Di Rocco A, Paoloni M, De Meis P, Angelini P. [Cholestatic jaundice secondary to distention of the gallbladder caused by cystic duct syndrome]. MINERVA CHIR 1992; 47:1497-9. [PMID: 1461525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The Authors describe a rare case of cholestatic jaundice which persisted due to compression of the biliary tract by a hugely swollen gallbladder due to cystic duct syndrome.
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Affiliation(s)
- G De Blasis
- Divisione di Chirurgia Generale, Presidio Ospedaliero, Avezzano, L'Aquilå
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